Currently in medical care in the United States, there are four main primary care specialties: family medicine, internal medicine, pediatrics, and geriatrics. Internal medicine is primary care for adults, pediatrics is primary care for children and infants, and geriatrics is primary care for seniors. Family medicine, the broadest specialty, is primary care for all ages.
A family medicine physician is a medical ‘home base’ for patients. They treat all ages, all sexes, all organs, and all diseases. They can see every member of the family, from birth through old age. This allows family medicine doctors to develop long-term relationships with their patients and to understand how their patients’ role in the family affects their health. They can provide check-ups, immunizations, screening services, gynecological exams and obstetric care, routine health care, and health counseling. When more specialized care is needed, a family medicine doctor can refer their patients to appropriate specialists. They can become educators and advocates for their patients in the sometimes overwhelming health care system.
As health care changes in this country, family medicine is a growing specialty for families and individuals who are seeking more personalized health care and a more personal relationship with their physician.
What is Nephrology?
Nephrology is the medical specialty that deals with diseases of the kidneys. Nephrologists deal with illnesses that are caused by lowered kidney function, such as certain types of hypertension. They also treat illnesses that harm the kidneys, such as acute kidney disease. Other specific diseases and disorders that are treated by a nephrologist include:
Chronic kidney disease
Polycystic kidney disease
Acute renal failure
Blood or protein in the urine (hematuria or proteinuria)
Nephritis, or inflammation of the kidneys
Pediatric nephrologists specialize in kidney diseases and disorders affecting infants and children. They may see children for inherited kidney diseases, recurring urinary tract infections, or high blood pressure, among other problems.
A nephrologist may use lab tests, ultrasound, and biopsies to diagnose the problem for their patients. They might prescribe treatments ranging from diet changes to dialysis to transplants. Most kidney problems are chronic, meaning that they last for a long time. Thus, nephrologists get to know their patients well and may treat them for many years.
Geriatrics is the subspecialty of internal medicine that provides primary care to older adults. Physical health tends to decline with age, and geriatricians work to manage such age-related concerns as chronic illness, frailty, multiple medications, and declining mental health to keep seniors as active and independent as possible.
Some of the most common concerns seen by a geriatrician include:
Mobility issues, including the need for canes and walkers, as well as preventing falls
Osteoporosis, a weakening of the bones, which affects as many as a quarter of all men and half of all women over fifty
Loss of hearing or vision
Incontinence, or the inability to control one’s bladder
Memory loss, including dementia and Alzheimer’s disease
A geriatrician may also provide their patients with comprehensive care that includes checking on their social health. Seniors are at increased risk for poverty, loneliness, abuse, and injuries in the home. As part of their health care, a geriatrician may inquire about family support, living conditions, or the ability of a patient to perform daily self-care tasks.
In some cases, a geriatrician may serve as an advisor to other physicians on a specific case or condition. However, most of the time geriatrics is a primary care specialty, and geriatricians provide routine health care to the older patients they work with.
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